Abstract
No cause is defined in the majority of children with hypopituitarism and they are labelled as ‘idiopathic’. Five patients 3 boys and 2 girls, aged from 2 to 22 years, underwent high resolution (GE9800) CT scans of the hypothalamic and pituitary regions. Four had pan-hypopituitarism, 1 with diabetes insipidus and 1 had isolated GH deficiency. Peak GH responses to hypoglycaemia (ITT) or glucagon were less than 5 mU/l and after bolus GHRH (1-29)NH2 in 3 patients, GH was 11.8, 11.5 and 10.2 mU/l, indicating hypothalamic GHRH deficiency. In 1 patient peak cortisol during ITT was 275 nmol/l compared with 690 nmol/l after bolus CRF 1-41 infusion. Prolactin levels were elevated in all subjects ranging from 562 to 1329 mU/l (normal value less than 360 mU/l). In each case CT scan demonstrated a definite enhancing lesion in the anterior hypothalamus, situated in the floor of the third ventricle, adjacent to the chiasm or in the region of the tuber cinerium. In 4 patients the pituitary gland was small. Biopsies were not performed. Repeat scan after 18 months in 2 subjects showed no change. Thus apart from hypopituitarism, the lesions produced no symptoms. We suggest that these may be of aetiological significance, correlating with endocrine evidence of hypothalamic dysfunction.
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Charlesworth, M., Ross, R., Grossman, A. et al. ENHANCING HYPOTHALAMIC LESIONS SHOWN ON HIGH RESOLUTION COMPUTERIZED TOMOGRAPHY IN PATIENTS WITH IDIOPATHIC HYPOPITUITARISM. Pediatr Res 20, 1188 (1986). https://doi.org/10.1203/00006450-198611000-00087
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DOI: https://doi.org/10.1203/00006450-198611000-00087